Evaluation of Cognitive Function Following Transcatheter Aortic Valve Replacement - 25/01/19
, Rehana de Vries, MSc b, 1, Pieter R. Stella, MD PhD a, Pierfrancesco Agostoni, MD, PhD a, c, Dirk H.M. Boelens, MD d, Romy C. van Jaarsveld, BSc a, Charlotte S. van Dongen, BSc a, Pieter A.F.M. Doevendans, MD, PhD a, Mariëlle H. Emmelot-Vonk, MD, PhD bRiassunto |
Background |
Transcatheter aortic valve replacement (TAVR) is associated with procedural-related neurological events and acute cognitive decline. However, data on the effect of TAVR on mid-term cognitive outcome are scarce. Therefore, we aimed to assess the impact of TAVR on mid-term cognitive outcome using different neurocognitive test batteries.
Methods |
Patients with severe aortic valve stenosis scheduled for TAVR were enrolled. Cognitive assessment was performed at baseline and 4 months post-TAVR using an eight-word verbal-learning test (“Immediate Recall Memory Test” [IRMT], “Delayed Recall Memory Test” [DRMT], “Recognition of Verbal Information Test” [RVIT]), global cognitive function (“Mini Mental State Examination” [MMSE]), and executive function (“Trail Making Test” [TMT], “Clock-Drawing Test” [CDT]).
Results |
A total of 30 patients (age: 81±6years, logistic EuroSCORE: 19±10%) completed the follow-up cognitive assessments. Postoperatively, 17% (n=5) developed delirium, 13% (n=4) received permanent pacemaker, and there were no cerebrovascular events. Mean hospital duration time was 5±2 days. Patients (n=22) who did not complete the follow-up cognitive assessments had comparable baseline, procedural and hospital outcome. At follow-up there was a significant improvement in IRMT (27±5 vs. 30±4, p=0.016), with a trend toward improved DRMT (4±2 vs. 5±2, p=0.079). Moreover, patients with lower baseline MMSE and IRMT improved significantly during the follow-up.
Conclusions |
Transcatheter aortic valve replacement was associated with an improved IRMT during follow-up. Both MMSE and IRMT were significantly improved among those with lower baseline scores.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : TAVR, POD, DOS, IRMT, DRMT, RVIT, MMSE, TMT, CDT
Keywords : TAVR, Cognition, Delirium, Verbal Memory Test, Trail Making Test
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Vol 27 - N° 12
P. 1454-1461 - dicembre 2018 Ritorno al numeroBenvenuto su EM|consulte, il riferimento dei professionisti della salute.
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